Hormone replacement therapy: evolution of body mass index, bone mineral density, and lipid profile
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Joaquín Cortés-Prieto
, Maria Lina Vicente-Hernanz
, Ana Cortés-García , Jerry Keller , Rosario Cintas del Rio and José Luis Brita-Paja Segoviano
Abstract
One hundred and eighty-five female never-hormone users with a mean age of 50.71 (SD=5.58) years upon initiation of treatment were studied before instauration and during treatment. The profile of patients subjected to the study included body mass index (BMI), bone mineral density (BMD), and lipid profile (LP). In our population, pretreatment values were within the normal range, which is why a hormone replacement therapy (HRT), conjugated equine estrogen plus medroxyprogesterone acetate, was administered to a healthy population of women for 9.82±5.42 years and follow-up comprised 1815.84 woman-years. To study the effects of treatment on the investigated clinical subjects, we resorted to comparative analyses of pretreatment and posttreatment mean values: descriptive and comparative hypothesis, followed by a repeated measurements design to investigate the evolution on three levels according to age groups just before the initiation of the treatment and on the other three levels during the treatment with a minimum follow-up of 9 years. On the basis of the numerical results, we were able to conclude that BMD decreased significantly (p=0.00) well above the values found on curves corresponding to these age groups. The total cholesterol decreased significantly at 2–3 years interval (p=0.04). The rest of the LP factors remained within a safe margin. Therefore, long-term HRT may be considered initially as a beneficial alternative in the treated study population.
Recognition is due to the two teams for their close and sustained collaboration, as well as to Mrs. Olga Boltova for her dedicated transcription of the text and figures.
References
1. Cortés-Prieto J, Vicente-Hernanz Ma L, Cortés-García A, Ahern H. Hormone replacement therapy: 1,815.84 woman-years of follow up. Main clinical events. Horm Mol Biol Clin Investig 2011; 8:479–90.Search in Google Scholar
2. Saleter SR, Walsh ME, Greyber E, Ormiston TM, Salpeter EE. Mortality associated with hormone replacement therapy in younger and older women. J Gen Intern Med 2004;19: 791–804.10.1111/j.1525-1497.2004.30281.xSearch in Google Scholar
3. Nachtigall LE, Nachtigall RH, Nachtigall RD, Beckman EM. Estrogen replacement therapy II. A prospective study in the relationship to carcinoma and cardiovascular and metabolic problems. Obstet Gynecol 1979;54:74–9.10.1097/00006250-197907000-00017Search in Google Scholar
4. Million Women Study Collaborators. Breast cancer and hormone-replacement therapy in the Million Women Study. Lancet 2003;362:419–27.10.1016/S0140-6736(03)14065-2Search in Google Scholar
5. Writing Group for the Women’s Health Initiative Investigators. Risk and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. J Am Med Assoc 2002;288:321–33.10.1001/jama.288.3.321Search in Google Scholar
6. Magnusson C, Baron JA, Correia N, Bergström R, Adami H-O, Persson I. Breast cancer risk following long-term estrogen and estrogen-progestin-replacement therapy. Int J Cancer 1999;81:339–44.10.1002/(SICI)1097-0215(19990505)81:3<339::AID-IJC5>3.0.CO;2-6Search in Google Scholar
7. Li Ch I, Malone KE, Porter PL, Weiss NS, Tang M-TC, Cushing-Haugen KL, Daling JR. Relationship between long-duration and different regimens of hormonal therapy and risk of breast cancer. J Am Assoc 2003;289:3254–63.10.1001/jama.289.24.3254Search in Google Scholar
8. Goodman N, Goldziher J, Ayala C. Critique of the report from the Writing Group of the WHI. Menopausal Med 2003; 10:1–4.Search in Google Scholar
9. Thorneycroft IH, Lindsay R, Pickar JH. Body composition during treatment with conjugated estrogens with and without medroxy progesterone acetate: analysis of the Women’s Health, Osteoporosis. Progestin, Estrogen (HOPE) Trial. Am J Obstet Gynecol 2007;197:137.e1–7.10.1016/j.ajog.2007.05.042Search in Google Scholar
10. Villareal DT, Binder EF, Yarasheski KE, Williams DB, Brown M, Sinacore DR, Kohrt WM. Effects of exercise training added to ongoing hormone replacement therapy on bone mineral density in frail elderly women. J Am Geriatr Soc 2003;51: 985–90.10.1046/j.1365-2389.2003.51312.xSearch in Google Scholar
11. Grey A, Cundy T, Evans M, Reid I. Medroxyprogesterone acetate enhances the spinal bone mineral density response to oestrogen in late post-menopausal women. Clin Endocrinol (Oxf) 1996;44:293–6.10.1046/j.1365-2265.1996.667488.xSearch in Google Scholar
12. Effects of hormone therapy on bone mineral density: results from the postmenopausal estrogen/progestin interventions (PEPI) trial. The Writing Group for the PEPI. J Am Med Assoc 1996;276:1389–96.10.1001/jama.276.17.1389Search in Google Scholar
13. Villareal DT, Binder EF, Williams DB, Schechtman KB, Yarasheski KE, Kohrt WM. Bone mineral density response to estrogen replacement in frail elderly women: a randomized controlled trial. J Am Med Assoc 2001;286:815–20.10.1001/jama.286.7.815Search in Google Scholar PubMed
14. Cauley JA, Robbins J, Chen Z, Cummings SR, Jackson RD, LaCroix AZ, LeBoff M, Lewis CE, McGowan J, Neuner J, Pettinger M, Stefanick ML, Wactawcki-Wende J, Watts NB, Women’s Health Initiative Investigators. Effect of estrogen plus progestin on risk of fracture and bone mineral density: the Women’s Health Initiative randomized trial. J Am Med Assoc 2003; 290:1729–38.10.1001/jama.290.13.1729Search in Google Scholar PubMed
15. Pinkerton JV, Dalkin AC. Combination therapy for treatment of osteoporosis: a view. Am J Obstet Gynecol 2007;197:559–65.10.1016/j.ajog.2007.07.022Search in Google Scholar PubMed
16. Lindsay R, Gallagher JC, Kleerekoper M, Pickar JH. Effect of lower doses of conjugated equine estrogens with and without medroxy progesterone acetate on bone in early postmenopausal women J Am Med Assoc 2002;287:2668–76.10.1001/jama.287.20.2668Search in Google Scholar PubMed
17. Ortiz-Nuñez DA, Mengchún-Lopez G, Hernandez-Marín I, Mendoza R, Ayala-Ruíz AR. Ausencia del efecto antiosteopenico de la terapia hormonal sustitutiva en mujeres postmenopausicas. Ginecol Obstet Mex 2004;72:349–55.Search in Google Scholar
18. Ko HS, Kim CJ, Ryu WS. Overweight and effect of hormone replacement therapy on lipid profiles in postmenopausal women. Korean J Intern Med 2005;20:33–9.10.3904/kjim.2005.20.1.33Search in Google Scholar PubMed PubMed Central
19. Yasui T, Umino Y, Takikawa M, Uemura H, Kuwahara A, Matsuzaki T, Maegawa M, Furumoto H, Miura M, Irahara M. Effects of postmenopausal hormone therapy every day and every other day on lipid levels according to difference in body mass index. Menopause 2005;12:223–31.10.1097/00042192-200512020-00018Search in Google Scholar PubMed
20. Gómez-Gerique JA, Gutiérrez-Fuentes JA, Montiya MT, Porres A, Rueda A, Avellanera A, Rubio MA. Perfíl lipídico de la población española: estudio DRECE (Dieta y Riesgo de Enfermedad Cardiovascular en España). Med Clin 1999;113:730–5.Search in Google Scholar
©2013 by Walter de Gruyter Berlin Boston
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- Hormone replacement therapy: evolution of body mass index, bone mineral density, and lipid profile
Articles in the same Issue
- Mini Review
- Dysthyronemia in normal concentrations of thyrotropin – analytical and clinical consequences
- Original Article
- Hormone replacement therapy: evolution of body mass index, bone mineral density, and lipid profile